Traumatic Lymphatic Injuries in Children

Faisal G. Qureshi, MD, MBA; Ali El Mokdad, MD; Genette Bergman, BS; Shellie Josephs, MD; Elie Balesh, MD

Product Details
Product ID: ACS-5642
Year Produced: 2018
Length: 8 min.


Lymphatic leaks from trauma in children are rare. The use of radiologic management for in children has not been reported. We present our experience. Patient 1: 15 year old assaulted in group home with difficulty breathing. Chest xray revealed a large right chylothorax effusion from a presumed thoracic duct injury. Despite conservative management he had high chest tube output (> 4000 cc/day). On hospital day 35 he underwent a VATS and thoracic duct ligation without success. On hospital day 50, he was taken to the interventional radiology suite where bilateral inguinal nodes were accessed and Lipodiol injected into the lymphatic channels. A leak was identified through 3 parallel right thoracic ducts; coil and cyanoacrylate glue embolization performed. Output dropped to 250 the next day and patient discharged on post procedure day 15. Patient 2: 8 year old boy involved in a MVC, underwent a left diaphragmatic rupture repair without small bowel injury. There was air and chyle in right retroperitoneum and a large drain placed. He had high drain output with enteral feeds despite conservative management. Radiologic evaluation revealed the drain 'irritating' the lymphatic channels and this was replaced with a smaller drain away from channels. Patient discharged after 4 days.